| Doctor Name: | DR. THOMAS TODD HICKMAN |
| NPI Number: | 1265674089 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.D.S.,P.A. |
| License Number: | 11044 |
| Business Practice Address: | 202 S Maple Ave Chestertown, MD - 216201626 |
| Business Phone Number: | 4107781297 |
| Business Fax Number: | 4107783552 |
| Mailing Address: | 202 S Maple Ave, CHESTERTOWN |
| State: | MD |
| Postal Code: | 216201626 |
| Phone Number: | 4107781297 |
| Fax Number: | 4107783352 |
| NPI Enumeration Date: | 03/25/2009 |
| NPI Last Update Date: | 03/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 11044 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |